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    STANDARD & GUIDELINE
  • ● STANDARD & GUIDELINE
    Neonatal Professional Committee of Chinese Medical Doctor Association
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    No abstract available

  • ● STANDARD & GUIDELINE
    CHEN Zi-Li, LIU Jing
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  • CLINICAL RESEARCH
  • ● CLINICAL RESEARCH
    LUO Fang, CHEN Zheng, MA Xiao-Lu, LIN Hui-Jia, BAO Yu, WANG Chen-Hong, SHI Li-Ping
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    OBJECTIVE: To explore the Infant Neurological International Battery (Infanib) as a screening tool for early detection of gross motor developmental delay in preterm infants discharged from NICU, and to predict their later neuromotor dysfunction (cerebral palsy or motor retardation). METHODS: A cohort of preterm infants who were admitted to the neonatal intensive care unit between June 2008 and March 2010 were enrolled in the study. Infanib assessment was performed at corrected age 3-4 months and 6-7 months. Peabody Developmental Motor scale-2 (PDMS-2) and neuro-examinations were used to confirm the last motor retardation. The sensitivity, specificity, positive predictive value and negative predictive value of the Infanib were calculated.ResultsA total of 147 preterm infants were participated in this study, and 129 infants were followed up at correct age 12 months or more than 12 months. Eleven (8.5%) had crerbral palsy, 28 (21.7%) had motor retardation, and 90 (69.8%) normal mortor development. The predictive validity of the Infanib at correct age 3-4 months (n=14) was: sensitivity 84.6%, specificity 75.6%, positive predictive value 60.0% and negative predictive value 91.9%. The predictive validity of the Infanib at correct age 6-7 months (n=117) was: sensitivity 100%, specificity 91.7%, positive predictive value 82.5% and negative predictive value 100%. CONCLUSIONS: The Infanib can be used as an appropriate screening tool and validity measurement for early detection of gross motor developmental delay in preterm infants.

  • ● CLINICAL RESEARCH
    HUANG Xi-Lin, CHEN Dan, LI Xiao-Ping, LI Ming-Yu, SHEN Jian-Feng, WU Xiao-Song
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    OBJECTIVE: To evaluate the clinical effectiveness and safety of intubation-surfactant-extubation (INSURE) method in the treatment of neonatal respiratory distress syndrome (NRDS), and to investigate its possible mechanisms. METHODS: Sixty-four premature infants, who were admitted for NRDS and treated with pulmonary surfactant from March 2010 to March 2012, were enrolled in the study. They were randomly divided into INSURE (n=32) and conventional mechanical ventilation (CMV) groups (n=32). The two groups were compared in terms of respiratory function, ventilation time, duration of oxygen therapy, complications, and prognosis, as well as expression of interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α) and serum ferritin (SF). RESULTS: Oxygenation index in the INSURE group was significantly higher than in the CMV group at 48 hours after treatment (P<0.05). Compared with the CMV group, the INSURE group showed significantly lower incidence of ventilator-associated pneumonia (VAP) and significantly shorter duration of oxygen therapy (P<0.05 for all comparisons). There were no significant differences in ventilation time and the incidence of pneumothorax, intracranial hemorrhage, necrotizing enteroolitis, bronchopulmonary dysplasia, and pneumorrhagia between the two groups (P>0.05). The levels of TNF-α and SF were significantly lower in the INSURE group than in the CMV group at 6, 24, 48, and 72 hours after treatment (P<0.05), while the level of IL-10 was significantly higher in the INSURE group than in the CMV group (P<0.05). CONCLUSIONS: INSURE method can improve the oxygenation function of the lung, decrease the incidence of VAP and shorten the duration of oxygen therapy in neonates with NRDS, which is probably due to the fact that this method can reduce the production of TNF-α and SF and inhibit the decrease of IL-10.

  • ● CLINICAL RESEARCH
    ZHANG De-Shuang, CHEN Chao, ZHOU Wei, CHEN Juan, MU De-Zhi
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    OBJECTIVE: To study the pathogens, drug sensitivity and risk factors for ventilator-associated pneumonia (VAP) in neonates. METHODS: Retrospective analysis was performed on the clinical data of 401 neonates who were admitted to the neonatal intensive care unit and received mechanical ventilation for 48 hours or longer from January 2008 to February 2012. Eighty-five of the 401 neonates suffered VAP. RESULTS: The main pathogens for VAP were Gram-negative bacteria (97%), including Klebsiella pneumoniae (51%), Acinetobacter baumannii (17%) and Escherichia coli (12%) as the three most frequent ones. The drug sensitivity test showed that these pathogens developed resistance to amoxicillin, amoxicillin/clavulanic acid, piperacillin, ceftazidime, cefazolin, and cefotaxime, with a susceptibility rate of below 15%, and demonstrated decreased sensitivity to imipenem and meropenem, with a susceptibility rate of below 75%. The independent risk factors for neonatal VAP included birth weight (OR=1.399, P<0.05), duration of mechanical ventilation (OR=1.966, P<0.01), length of hospital stay (OR=1.812, P<0.01), times of tracheal intubation (OR=2.056, P<0.01), and 1 min Apgar score (OR=2.146, P<0.01). CONCLUSIONS: The incidence of neonatal VAP is influenced by many factors. The main pathogens for neonatal VAP are Gramnegative bacteria and antibacterial agents should be properly used according to drug sensitivity test results. Comprehensive prevention and control measures should be taken to reduce the incidence of VAP.
  • ● CLINICAL RESEARCH
    JIANG Hua, HU Wen-Ting, CHEN Jing, LUO Chang-Ying, WANG Jian-Min, ZHOU Min, YE Qi-Dong, TANG Yan-Jing, LUO Cheng-Juan
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    OBJECTIVE: To investigate the therapeutic efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with chronic myelogenous leukemia (CML), and to analyze the possible prognostic factors.MethodsThe clinical data of 20 children with CML who had received allo-HSCT was analyzed retrospectively to investigate possible prognostic factors, including age, sex, interval between diagnosis and transplantation, HLA matching between donors and recipients, illness status on transplantation and acute and chronic graft-versus-host disease (GVHD).ResultsAt the end of follow-up, 13 of the 20 treated children had disease-free survival (DFS) and the rest (7 cases) died. Four died of severe acute GVHD, two of chronic GVHD and its complications, and one of relapse after transplantation. The three-year DFS was (64.6±1.1%). As shown by the univariate analysis, age was the most important prognostic factor in children with CML who had received allo-HSCT (P<0.05), and in children over 10 years, the prognosis was poor. No other of the above factors had a significant impact on prognosis (P>0.05). The multivariate logistic regression analysis also confirmed age as the only prognostic factor (P<0.01). Severe acute and/or chronic GVHD was the most important cause of patient death. 10/10 HLA-matched donors could improve the transplantation outcome.ConclusionsAllo-HSCT is an effective treatment for children with CML. To improve the prognosis and treatment outcome, children with CML aged over 10 years should receive allo-HSCT as early as possible. 10/10 HLA-matched donors are preferred in allo-HSCT and GVHD should be prevented.
  • ● CLINICAL RESEARCH
    WANG Xi-Ge, ZHOU Yu-Jie, WANG Dan-Feng, WANG Xuan
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    OBJECTIVE: To explore the relationship of telomerase RNA component (hTERC) and the telomerase reverse transcriptase (hTERT) with telomerase activity in the marrow hemopoietic stem cells of children with aplastic anemia (AA). METHODS: Fifty-two children with chronic AA, 13 children with acute AA and 21 normal controls were enrolled in the study. Telomerase activity and the expression of mRNA of hTERT and hTERC were detected by Telomeric Repeat Amplification Protocol (TRAP) with silver staining and real-time Q-PCR respectively. RESULTS: Levels of telomerase activity in both the chronic and acute AA groups were higher than in the control group (P<0.01). The AA groups had significantly higher expression of hTERT mRNA than the control group (P<0.01). The chronic AA group had higher expression of hTERT mRNA and telomerase activity than the acute AA group (P<0.05). There was no significant difference in the expression of hTERC mRNA among the three groups (P=0.812). There was a significant correlation between the expression of hTERT mRNA and telomerase activity (r=0.660, P<0.01). CONCLUSIONS: Expression of telomerase activity may be involved in the pathophysiology and development of AA, and hTERT plays a crucial role in expression of telomerase activity.
  • ● CLINICAL RESEARCH
    XIANG Li, FU YA-Nan, LI Zhen, REN Yi-Xin, RAO Xiao-Chun
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    OBJECTIVE: To investigate the value of fractional nitric oxide concentration in exhaled breath (FeNO) in assessing the level of asthma control in children. METHODS: A total of 226 asthmatic children were divided into controlled asthma (n= 86), partially controlled asthma (n=63), and uncontrolled asthma groups (n=77). Ninety healthy children were enrolled as controls. FeNO was measured for both asthmatic and healthy children using the Swedish-designed NIOX system. RESULTS: The control group had an FeNO of 14±6 ppb, the controlled asthma group had an FeNO of 29±26 ppb, the partially controlled asthma group had an FeNO of 32±30 ppb, and the uncontrolled asthma group had an FeNO of 40±32 ppb. The three asthma groups showed significantly higher FeNO than the control group (P<0.05). The uncontrolled asthma group showed significantly higher FeNO than the controlled asthma group (P<0.05), but there were no significant differences in FeNO between the partially controlled and uncontrolled asthma groups and between the partially controlled and controlled asthma groups (P>0.05). CONCLUSIONS: Asthmatic children have significantly higher FeNO than healthy children, and FeNO is correlated with the level of asthma control.
  • ● CLINICAL RESEARCH
    KE Li-Qin, WANG Feng-Mei, LI Yin-Jie, LUO Yun-Chun
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    OBJECTIVE: To study the epidemiological characteristics of Mycoplasma pneumoniae pneumonia (MPP) in children, and to provide a basis for diagnosis and treatment. METHODS: The serum level of Mycoplasma pneumoniae antibody IgM (MP-IgM) was measured by enzyme-linked immunosorbent assay for 3156 hospitalized children with confirmed community acquired pneumonia from February 2011 to January 2012. The antigens of seven respiratory viruses were detected in the nasopharyngeal secretions of children with MPP. RESULTS: MP-IgM was detected in 427 of the 3156 patients, with a positive rate of 13.53%. The infection rate in female patients was significantly higher than in male patients (16.30% vs 11.70%; P<0.01). The MP-IgM detection rates were 3.6%, 12.5%, 19.2%, and 24.4% in children aged under 1 year, 1-3 years, 3-6 years and 6-14 years respectively (P<0.01), and the total MP-IgM detection rate in children aged under 3 years was significantly lower than in children over 3 years (P<0.01). The MP-IgM detection rate varied with the seasons and was significantly higher in summer and autumn than in winter and spring (19.18% vs 9.61%; P<0.01). Of the 427 MP-IgM-positive children, 60 (14.1%) were infected with respiratory viruses, and the highest proportion of which was respiratory syncytial virus. CONCLUSIONS: MPP is sporadic throughout the whole year, with a higher incidence in summer and autumn. MPP occurs mostly in preschool and school-age children, and there is mixed infection of MP and respiratory viruses.
  • ● CLINICAL RESEARCH
    XU Qiao, LIN Shu-Xiang, GUO Wei, DONG Han-Quan, WANG Wei, PENG Lin
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    OBJECTIVE: To investigate the infection rate and genotypes of Mycoplasma pneumoniae (MP) by examining bronchoalveolar lavage fluid from children with community acquired pneumonia (CAP). METHODS: Polymerase chain reaction (PCR) was used for detecting MP in bronchoalveolar lavage fluid from 220 children hospitalized with CAP, and the accuracy was confirmed by quantitative real-time PCR. Positive samples were digested with HaeⅡ and Hae Ⅲ and compared with standard strain to analyze the genotypes of MP from positive samples. The accuracy of genotyping was confirmed by sequencing the amplified products of some randomly selected positive samples. RESULTS: The positive rate of MP in 220 samples was 55.0% (121/220). MP infection occurred mostly in preschool and school-age children (63.5%, 101/159), and the lowest positive rate was seen in children aged under 6 months (20%, 1/5). The positive rate showed no significant differences between sexes and between seasons. Sixty randomly selected MP-positive samples showed a genotype of P1 type 1 after restriction digestion, which was further confirmed by sequencing of 4 samples. CONCLUSIONS: MP is one of the main pathogens of pneumonia in children, and the MP infection rate is significantly correlated with age. The dominant genotype of MP in children is P1 type 1.
  • ● CLINICAL RESEARCH
    LIU Xiang-Teng, WANG Gui-Lan, LUO Xu-Feng, CHEN Yu-Lan, OU Jun-Bin, HUANG Juan, RONG Jia-Yan
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    OBJECTIVE: To investigate the spectrum of pathogens for community-acquired pneumonia (CAP) in children, and to provide a basis for the diagnosis and treatment of CAP. METHODS: Respiratory secretions and venous blood samples were collected from 1560 children with CAP aged from one month to 9 years within 2 hours after admission, for detection of multiple pathogens. Respiratory virus antigens in nasopharyngeal swab specimens were detected by immunofluorescence. Sputum was used for bacterial culture. Levels of Mycoplasma pneumoniae (MP)-IgM and Chlamydia pneumoniae (CP)-IgM in venous blood were measured by enzyme-linked immunosorbent assay. RESULTS: A total of 579 strains of bacteria were isolated from all respiratory secretions, including 213 (36.8%) Gram-positive strains and 366 (63.2%) Gram-negative strains. The five most common strains were Haemophilus influenzae (7.50%), Streptococcus pneumoniae (6.73%), Staphylococcus aureus (6.35%), Moraxella catarrhalis (5.19%), and Escherichia coli (3.46%), wherein the beta-lactamase-producing strains accounted for 3.3% of all strains. The non-bacterial pathogens mainly included respiratory syncytial virus (12.88%), MP (7.88%), and CP (8.91%). Mixed infection of pathogens was serious, and the mixed infection of respiratory syncytial virus with Haemophilus influenzae infections were the most common. For most pathogens, the infection rate was higher in children aged under one year than in those aged over one year. CONCLUSIONS: Haemophilus influenzae, respiratory syncytial virus, MP and CP are the main pathogens for children with CAP. For most pathogens, the infection rate is higher in children aged under one year than in those aged over one year. Mixed infection rate of pathogens is high.
  • ● CLINICAL RESEARCH
    WANG Xiu-Fang, GUO Zhi-Lan, LEI Rui-Rui, HAN Ying
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    OBJECTIVE: To study changes to CD4+CD25high+CD127low regulatory T cells (Treg) in peripheral blood from children with bronchiolitis, and to explore its clinical significance. METHODS: Thirty-one children with bronchiolitis and aged under two years were randomly enrolled as the bronchiolitis group, and 25 under two-year-olds with bronchopneumonia were randomly enrolled as the bronchopneumonia group. A further twenty-five children with non-infectious diseases such as hernia and renal calculus served as the control group. The level of CD4+CD25high+CD127lowTreg in peripheral blood was measured by multi-color detection and multi-parameter flow cytometry. RESULTS: The proportion of CD4+CD25high+CD127lowTreg in peripheral blood in the bronchiolitis group (8.0%±2.1%) was significantly lower than in the bronchopneumonia (9.6%±2.6%; P<0.05) and control groups (11.3%±2.9%; P<0.05). CONCLUSIONS: CD4+CD25high+CD127lowTreg level in peripheral blood may be an index of immunological function in infants. A decreased level of CD4+CD25high+CD127lowTreg in peripheral blood suggests that Treg cells may be involved in the pathogenesis and development of bronchiolitis.

  • ● CLINICAL RESEARCH
    LV Ling, LIU Jia-Yue, MA Jing, LIN Shu-Xiang, HUANG Le
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    OBJECTIVE: To measure levels of cytokines including IL-1β, IL-12, IL-18 and TNF-α in children with newly diagnosed type 1 diabetes and to analyze their correlation with clinical indices such as infection and onset time. METHODS: A total of 33 children with newly diagnosed type 1 diabetes were assigned to the case group, and 27 healthy children to the control group. The case group was further divided into increased white blood cell (WBC) and normal WBC subgroups according to peripheral WBC level. The serum levels of cytokines including IL-1β, IL-12, IL-18 and TNF-α were measured by enzyme-linked immunosorbent assay. Blood pH, blood sugar, blood lactate, fructosamine, peripheral leukocytes and neutrophils and some other clinical indices were also measured. RESULTS: The level of IL-12 in the case group was higher than in the control group (P<0.001). In the case group, the level of IL-18 was negatively correlated with onset time (r=0.413, P=0.015), the neutrophil count was positively correlated with IL-1β level (r=0.413, P=0.023) and the WBC count was positively correlated with IL-18 level (r=0.352, P=0.038). IL-1β, IL-12 and IL-18 levels in the increased WBC subgroup were higher than in the normal WBC subgroup (P<0.05 for all comparisons). CONCLUSIONS: Cytokine secretion disorders of Th1 cells exist in children with type 1 diabetes. Infections may induce cytokine secretion and might contribute to the early onset of diabetes.
  • ● CLINICAL RESEARCH
    ZHU Ying, DONG Yang, XU Da-Liang, JIANG Jia-Yun
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    OBJECTIVE: To observe the therapeutic effect of continuous blood purification (CBP) combined with hemoperfusion (HP) in children with hemolytic-uremic syndrome (HUS) and to investigate its possible mechanism. METHODS: Eight children with HUS received CBP combined with HP on the basis of internal medicine treatment in the acute stage. Before and after treatment, serum levels of interleukin-6 (IL-6), IL-8 and tumor necrosis factor-α (TNF-α) were measured by chemiluminescence method, and levels of blood urea nitrogen (BUN), serum creatinine (SCr), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase (CK), creatine kinase MB (CKMB), hemoglobin (Hb), platelet (PLT) and C-reactive protein (CRP) were measured. Eight healthy children undergoing physical examination were used as controls. RESULTS: The 8 children with HUS all survived after CBP combined with HP and showed improved conditions. They had increased Hb and PLT levels and decreased serum levels of IL-6, IL-8, TNF-α, BUN, SCr, ALT, CK and CRP after treatment (P<0.05). CONCLUSIONS: CBP combined with HP can quickly remove pathogenic factors, continually eliminate inflammatory mediators and toxins, and reverse multiple organ dysfunction, and is one of effective methods for treating HUS in children.
  • ● CLINICAL RESEARCH
    ZHAO Ya-Ling, MA Run-Mei, HUANG Yong-Kun, LIANG Kun, DING Zheng-Bo
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    OBJECTIVE: To investigate whether breastfeeding can reduce the risk of childhood overweight in the offspring of mothers with gestational diabetes mellitus (GDM). METHODS: Follow-up was performed on 1189 offspring of mothers with GDM between January 2003 and December 2009. The influence of the manner and duration of breastfeeding between 0 to 3 months after birth on the risk of childhood overweight in the offspring of mothers with GDM was analyzed by logistic regression. RESULTS: After correcting confounding factors such as pre-pregnancy BMI, gestational weight gain, gestational blood sugar, sex, birth weight, age and farther′s body weight, it was found that the risk of childhood overweight in the offspring who received exclusive breastfeeding during the first 3 months after birth was lower than in the artificial feeding group (OR: 0.479, 95%CI: 0.256-0.897). Offspring who were breastfed for 0 to 3 months, 4 to 6 months and over 6 months had a lower risk of childhood overweight than the artificial feeding group (OR: 0.456, 95%CI: 0.233-0.827; OR: 0.29, 95%CI: 0.103-0.817; OR: 0.534, 95%CI: 0.280-0.970), offspring who were breastfed for 4 to 6 months had a lower risk of childhood overweight than those who were breastfed for 0 to 3 months (OR: 0.372, 95%CI: 0.129-0.874), and offspring who were breastfed for more than 6 months did not show significantly lower risk of overweight than those who were breastfed for less than 6 months (OR: 0.769, 95%CI: 0.470-1.258). CONCLUSIONS: Within 3 months of birth, breastfeeding, especially exclusively, may reduce the risk of childhood overweight in the offspring of mothers with GDM. Within 6 months of birth, the risk of childhood overweight decreases as the duration of breastfeeding increases, but prolonging the duration of breastfeeding cannot necessarily reduce the risk of childhood overweight after postnatal six months.
  • EXPERIMENTAL RESEARCH
  • ● EXPERIMENTAL RESEARCH
    LI Yong-Fu, JIN Mei-Fang, SUN Bin, FENG Xing
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    OBJECTIVE: To study the effects of biological clock protein on circadian disorders in hypoxic-ischemic brain damage (HIBD) by examining levels of CLOCK and BMAL1 proteins in the pineal gland of neonatal rats. METHODS: Seventy-two 7-day-old Sprague-Dawley (SD) rats were randomly divided into sham-operated and HIBD groups. HIBD model was prepared according to the modified Levine method. Western blot analysis was used to measure the levels of CLOCK and BMAL1 in the pineal gland at 0, 2, 12, 24, 36 and 48 hours after operation. RESULTS: Both CLOCK and BMAL levels in the pineal gland increased significantly 48 hours after HIBD compared with the sham-operated group (P<0.05). There were no significant differences in levels of CLOCK and BMAL proteins between the two groups at 0, 2, 12, 24 and 36 hours after operation (P>0.05). CONCLUSIONS: Levels of CLOCK and BMAL1 proteins in the pineal gland of rats increase significantly 48 hours after HIBD, suggesting that both CLOCK and BMAL1 may be involved the regulatory mechanism of circadian disorders in rats with HIBD.
  • ● EXPERIMENTAL RESEARCH
    LUAN Bin, WANG Ya-Zhe, ZHANG Yan-Li, GU Hui-Ru, LI Yan-Ling, ZHAO Jie
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    OBJECTIVE: To establish a mouse model of asthmatic airway remodeling and investigate the effects of 1,25-(OH)2D3 on airway structure and T cell immunoglobulin mucin protein-4 (TIM-4) expression in asthmatic mice. METHODS: Thirty female mice (BALB/c strain) were randomly divided into control, asthma and 1,25-(OH)2D3 intervention groups. An asthmatic mouse model was induced using ovalbumin. Lung tissue of the mice was collected, mRNA expression of TIM-4 was evaluated by RT-PCR and airway remodeling and protein expression of TIM-4 were observed by hematoxylineosin staining and immunohistochemistry.RESULTS: Typical airway remodeling was found in the asthma group, and TIM-4 expression in this group was significantly higher than in the control group (105±9 vs 42±5; P<0.05). Compared with the asthma group, the 1,25-(OH)2D3 intervention group showed improvement in airway remodeling and a decrease in TIM-4 expression (78±6) (P<0.05). CONCLUSIONS: TIM-4 may be involved in the airway remodeling of mice. As a new type of immunoregulator, 1,25-(OH)2D3 can downregulate expression of TIM-4 in the lungs and improve airway remodeling in asthmatic mice.

  • ● EXPERIMENTAL RESEARCH
    GAO Fang-Fang, LIU Ge-Li, ZHENG Rong-Xiu, JIANG Li-Hong, BAO Peng-Li
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    OBJECTIVE: To investigate the correlation between visceral adipose tissue-derived serine protease inhibitor (vaspin) concentration and insulin sensitivity in the visceral adipose tissue of young obese Sprague-Dawley (SD) rats. METHODS: Twenty-four SD rats which had been weaned 3 weeks before were randomly divided into two groups (n=12 each) to receive a high-fat and normal diet. The weight and abdominal circumference (AC) of each rat were measured, the fasting plasma glucose (FPG) and fasting insulin (FINS) in blood from the angular vein were measured after 12 hours of fasting and blood glucose (BG) and insulin (INS) levels in blood from the angular vein were measured at 60 and 120 minutes after intraperitoneal injection of 50% glucose (2 g/kg). The rats were sacrificed, and their liver and visceral adipose tissue were weighed. The vaspin concentration of the visceral adipose tissue in each rat was measured using ELISA. Correlation analysis was performed on the vaspin concentration and other indices. RESULTS: Compared with the normal diet group, the high-fat diet group showed significantly higher weight, AC, weight of visceral adipose tissue, FPG, FINS, 120 minute INS level, vaspin concentration, homeostasis model assessment for insulin resistance (HOMA-IR) and homeostasis model assessment of β cell function (HOMA-β) (P<0.05) Insulin sensitivity index (ISI) was significantly lower (P<0.01). Vaspin concentration was positively correlated with visceral adipose tissue and liver weight, AC, 120 minute INS level, FPG, FINS, HOMA-IR and HOMA-β (P<0.05), and negatively correlated with ISI (P<0.05). CONCLUSIONS: High expression of vaspin is associated with insulin resistance in young obese SD rats. Vaspin is presumably an adipocytokine that can increase insulin sensitivity, promote insulin secretion by islet β-cells and improve glucose tolerance, and it may be involved in insulin resistance and the disturbance of carbohydrate metabolism.
  • CASE REPORT
  • ● CASE REPORT
    SUN Zeng-Xian, LAN Ju-Hong
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    No abstract available
  • ● CASE REPORT
    ZHONG Yan-Lan, DANG Xi-Qiang
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    No abstract available
  • ● CASE REPORT
    LIU Jing, LU Biao
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    No abstract available